FUTURE OFDENTISTRYDemographic Trends........................................................................................................................
The world population increases by roughly a billion
people each decade. Today, there are about 281 mil-
lion people in the United States; by the year 2050, that
figure is expected to reach approximately 400 million.
At the same time that America is seeing an aging
of its population, it is also becoming more racially
and ethnically diverse. Such demographic changes
are expected to alter disease patterns as well as cul-
tural attitudes and expectations about health care
and lifestyle behaviors. As a corollary, health care
delivery systems and the services they provide will
also change.
Economic Trends..............................................................................................................................
Like all other elements of society, the dental sector
is influenced by the overall performance of the econo-
my. The supply and demand for dental care determine
the amount and types of dental services provided, as
well as the geographic distribution of dentists, the
average income levels of dental professionals, the
financial strength of dental practices and the number
of applicants to and graduates from dental schools.
The robust economy of the past two decades has
greatly benefited the dental profession. Between
1970 and 1996, real gross domestic product (GDP)
doubled, representing an annual real growth rate of
2.7 percent. Through most of the 1990s, unemploy-
ment, interest rates and inflation have remained low
compared to earlier decades, and prices today are
rising at an annual rate of slightly more than 2 per-
cent. The last genuine economic contraction
occurred in 1991, and even that downturn was brief
and mild. The ensuing decade has been one of unin-
terrupted prosperity and steady growth.
Dental markets have adjusted to supply-side
forces by reducing the number of new graduates and
to demand-side forces by changing the mix of serv-
ices provided in response to changing disease pat-
terns. Overall, fee increases have been moderate,
and a smaller proportion of overall economic
resources have been used to provide dental care. As
a result, an increasing number of Americans have
access to needed treatment.
Science and Technology Trends.........................................................................................................
The rate of scientific and technological advance-
ment has accelerated in recent years, a trend that
will continue into the next decade and beyond.
Through research, dentistry has improved its under-
standing of the causes and sequelae of diseases and
conditions and their interrelationships. The social,
biological, and physical sciences have evolved and
begun to merge, fostering an improved understand-
ing of human health.
Through sophisticated biotechnology research,
science is mapping the human genome and gaining
knowledge of the organisms and microbes associat-
ed with such conditions as dental caries, oral can-
didiasis and periodontal diseases. Genetically engi-
neered animals and foods have become a reality, and
it is now possible to mimic nature by applying bio-
mimetics to design and fabricate new drugs, tissues
and organs. With these developments come critical
ethical, legal and social questions that must be
addressed.
Miniaturization and nanotechnology provide addi-
tional tools contributing to improved health care and
communication. These technologies have tremendous
potential, particularly in connection with optical laser
systems and computer-assisted informatics. Infor-
mation technology is revolutionizing the teaching and
delivery of health care through virtual-reality systems,
telemedicine and teledentistry.
The Internet makes global communications pos-
sible, increasing access to information around
the world, breaking down national and other
barriers and accelerating the speed of communication.
Among other effects, these new technologies are
improving efficiency in patient scheduling, referrals and
record keeping. New technologies also are changing
traditional methods of disseminating information
through scientific journals, books and other documents.
Increasing numbers of Americans are using the Internet
to seek health information and make health care choices.
The frenetic pace of this activity has an important
downside: some of the materials disseminated in this
way are bound to be of questionable value and accuracy.
The decades ahead will witness advances in sci-
ence and technology as yet unforeseen. Dentistry
will benefit from these advances and must be inti-
mately involved in their progression.Advancing Determinants of Health..................................................................................................
Over the past 50 years, a growing understanding
of the many factors that affect health has spawned
various public health initiatives in the United States
and other nations. Underlying these initiatives is theIntroduction